Living Alone with Cognitive Impairment: A Growing Concern in the US
A Hidden Population
Sociologist Elena Portacolone was taken aback when she discovered that many of the older adults she visited at home for a research project were confused when she came to the door. They had forgotten the appointment or couldn’t remember speaking to her. It seemed clear that they had some type of cognitive impairment. Yet, they were living alone.
The Research
Portacolone’s review of the research literature revealed that there was little information on this group. "I realized this is a largely invisible population," she said. To fill this gap, Portacolone leads the Living Alone with Cognitive Impairment Project at the University of California-San Francisco.
The Numbers
The project estimates that at least 4.3 million people 55 or older who have cognitive impairment or dementia live alone in the United States. About half have trouble with daily activities such as bathing, eating, cooking, shopping, taking medications, and managing money, but only 1 in 3 received help with at least one such activity.
The Challenges
Compared to other older adults who live by themselves, people living alone with cognitive impairment are older, more likely to be women, and disproportionately Black or Latino, with lower levels of education, wealth, and homeownership. Yet, only 21% qualify for publicly funded programs such as Medicaid that pay for aides to provide services in the home.
The Consequences
Imagine what this means. As memory and thinking problems accelerate, these seniors can lose track of bills, have their electricity shut off, or be threatened with eviction. They might stop shopping (it’s too overwhelming) or cooking (it’s too hard to follow recipes). Or they might be unable to communicate clearly or navigate automated phone systems. A variety of other problems can ensue, including social isolation, malnutrition, self-neglect, and susceptibility to scams. Without someone to watch over them, older adults on their own may experience worsening health without anyone noticing or struggle with dementia without ever being diagnosed.
Seeking Help
Seeking to learn more about these seniors’ experiences, Portacolone and her collaborators have followed nearly 100 older adults with cognitive impairment who live alone. They listed some concerns people told researchers they worried most about: "Who do I trust? When is the next time I’m going to forget? If I think I need more help, where do I find it? How do I hide my forgetfulness?"
Conclusion
The need for assistance is clear. As the population ages, it is essential to recognize the challenges faced by older adults with cognitive impairment who live alone. By providing more support and resources, we can help them maintain their independence, alleviate their concerns, and ensure they receive the care and assistance they need.
FAQs
Q: How common is cognitive impairment among older adults?
A: At least 4.3 million people 55 or older who have cognitive impairment or dementia live alone in the United States.
Q: Who is most affected by cognitive impairment?
A: Older adults with lower levels of education, wealth, and homeownership are disproportionately affected.
Q: What are the consequences of living alone with cognitive impairment?
A: Severe social isolation, malnutrition, self-neglect, and susceptibility to scams can ensue, as well as worsening health and unaddressed dementia.
Q: How can we improve support for these seniors?
A: By recognizing the need for more assistance and providing resources to help them maintain their independence, we can alleviate their concerns and ensure they receive the care and assistance they need.
